Abstract Details

Title Prevalence of Cerebrovascular Events in Extraluminal Protruding Intracranial Atherosclerotic Plaques: Analysis of Intracranial Vessels from the Nun Study

Topic Child Neurology/Developmental Neurobiology

Presentation(s) P03 - (-)

Poster/Presentation
Number 009

Objective

Background BACKGROUND: Pathophysiology and clinical significance of extraluminal protruding plaques in intracranial arteries is not fully understood. It is important to identify the frequency of cerebrovascular accidents in patients having such plaques.

Design/Methods DESIGN/METHODS: A random sample of 100 subjects from Nun Study repository of post-mortem intracranial arteries was inspected. The Nun Study is a longitudinal study of aging and Alzheimer's disease. A total of 61 subjects with visible atherosclerotic changes were selected. The specimens were placed in a liquid container and an angiographic catheter was placed in vessel of interest. Using iodinated contrast media, angiography was obtained in multiple planes. Percentage luminal stenosis was measured using proximal or distal normal vessel as reference. Using microscopic images, extraluminal protruding plaques was then sequentially measured.

Results RESULTS: Out of 61 subjects, 41(67%) had angiographically detectable atherosclerotic plaques. Thirteen (13%) subjects had plaques with outside protrusion and the remaining 7(20%) subjects have neither angiographic stenosis nor outside protrusion. Mean life expectancy was higher in patients with angiographic stenosis and outside plaque protrusion(59 and 51 versus 47). The prevalence of lacunar infarct, large infarct(>1.5cm) in autopsy, and infarction identified in patient's brain MRI were all higher in patients with outside plaque protrusion than patients without wall thickness change(38% versus 29%, 37% versus 31%, and 15% versus 14%, respectively). The prevalence of dementia in patients with angiographic stenosis, outside protrusion of plaque, and no wall thickness change was 80%, 20%, and zero, respectively.

Conclusions CONCLUSIONS: Outside protruding plaques without angiographic stenosis appear to be responsible for ischemic events in patients with cryptogenic stroke. Higher prevalence of stroke in these patients warrants the use of newer imaging modalities like high resolution magnetic resonance imaging to identify patients who are at high risk of cerebrovascular events.

Authors/Disclosures
PRESENTER	No disclosure on file
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for onsulting or Advisory Boards: Alexion, Antisense Therapeutics/Percheron, Avotres, Biogen, Clene Nanomedicine, Clinical Trial Solutions LLC, Endra Life Sciences, Cognito Therapeutics, Genzyme, Genentech, Immunic, Klein-Buendel Incorporated, Kyverna Therapeutics, Inc. , Linical, Merck/Serono, Noema, Neurogenesis, Perception Neurosciences, Protalix Biotherapeutics, Regeneron, Revelstone Consulting, Roche, SAB Biotherapeutics, Sapience Therapeutics, Scott&Scott LLP, Tenmile.. Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Data and Safety Monitoring Boards: Applied Therapeutics, AI therapeutics, AMO Pharma, Argenx, Astra-Zeneca, Avexis Pharmaceuticals, Bristol Meyers Squibb, CSL Behring, Cynata Therapeutics, DiamedicaTherapeutics, Horizon Pharmaceuticals, Immunic, Inhibrix, Karuna Therapeutics, Kezar Life Sciences, Medtronic, Merck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma Holdings, Prothena Biosciences, Novartis, Pipeline Therapeutics (Contineum), Regeneron, Sanofi-Aventis, Teva Pharmaceuticals, United BioSource LLC, University of Texas Southwestern.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.
Shahram Majidi, MD (Icahn School of Medicine at Mount Sinai)	Dr. Majidi has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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